This is a simple but crucial test which should be done for every person after a stroke. Usually administered by nursing staff who will ask the person to take small teaspoons of water. If the person can do this without coughing, they will then be asked to drink half a cup of water. If the person does cough or their throat sounds moist this may indicate a swallowing problem when liquids could enter the lung rather than the stomach. This is known as aspiration and can lead to serious complications such as pneumonia. If the person has a swallowing problem they will then be put onto a “nil by mouth” regime until a speech and language therapist has reassessed the swallow in more detail. They will then decide if a further test is needed called videofluoroscopy this is an X ray of the person while they swallow. The person may also require an intravenous drip in the arm to supply fluids which they cannot take by mouth and a tube from the nose down into the stomach for food and nutrition. At this point a dietitian will advise. This will be reviewed as the person starts to improve and can often be removed later in the recovery.
It is important that carers and visitors do not give the person any food or drinks when visiting, including ice cubes or ice chips, until staff know if the person has a safe swallow.
The following film clip shows how a nurse would check the person’s ability to swallow safely after a stroke. Please note carers are not expected to do this assessment. It should only be done by a trained nurse or therapist.
(To make the film clip larger, click on the arrows at the bottom right of the film clip.)
For more information see Topic 3: Practical advice and tips for carers > Swallowing,eating and nutrition on this website. This includes how to modify food and drinks for people with swallowing problems.